Publications by authors named "Alexander Petter-Puchner"

Lung cancer is the most frequent cause of cancer-related death worldwide. The patient’s outcome depends on tumor size, lymph node involvement and metastatic spread at the time of diagnosis. The prognostic value of lymph and blood vessel invasion, however, is still insufficiently investigated.

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  • Euglycemic diabetic ketoacidosis (EDKA) is a serious condition associated with antidiabetic medications called SGLT2 inhibitors, particularly relevant during surgery.
  • A literature review identified 33 articles highlighting risk factors for EDKA, including infection, fasting, surgical stress, and reduced insulin dosage.
  • To prevent delayed diagnosis and complications, SGLT2 inhibitors should be stopped 24-48 hours before surgery and only resumed when the patient is stable.
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  • The sublay technique for incisional hernia repair shows advantages over the onlay technique in meta-analyses and systematic reviews, though onlay may still be useful in certain cases.
  • Unadjusted analysis of data from the Herniamed Registry found onlay operations tended to be performed more frequently for smaller defects and in women, but when propensity score matching was applied, outcomes between the two techniques were comparable.
  • In specific patient groups with small and lateral incisional hernias and more women, the results suggest that both sublay and onlay techniques yield similar outcomes within one year post-operation.
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Introduction: Negative pressure wound therapy (NPWT) is widely used in the treatment of open abdomen (OA). The use of dynamic fascial sutures (DFS) increases the rate of successful delayed closure by reducing fascial lateralization. We recently published a prospective controlled trial including 87 patients undergoing abdominal surgery for secondary peritonitis between 2007 and 2012.

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Abdominal wall hernia is a recurrent issue world-wide and requires the implantation of over 1 million meshes per year. Because permanent meshes such as polypropylene and polyester are not free of complications after implantation, many mesh modifications and new functionalities have been investigated over the last decade. Indeed, mesh optimization is the focus of intense development and the biomaterials utilized are now envisioned as being bioactive substrates that trigger various physiological processes in order to prevent complications and to promote tissue integration.

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Background: Inguinal hernia repair is one of the most common operations in general surgery. The Lichtenstein tension-free operation has become the gold standard in open inguinal hernia repair. Despite the low recurrence rates, pain and discomfort remain a problem for a large number of patients.

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Introduction: The aim of this prospective controlled trial was the definition of the optimal timepoint for delayed closure after negative pressure wound therapy (NPWT) in the treatment of the open abdomen (OA) in septic patients after abdominal surgery. The delayed closure of the abdominal wall after abdominal NPWT treatment is often problematic due to the lateralization of the fascial edge leading to unfavorably high tensile forces of the adapting sutures in the midline. We present the results of an innovative combination of NPWT with a new fascial-approximation technique using dynamic fascial sutures (DFS) and delayed closure of the abdominal wall.

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Background: The spray application of fibrin sealant (FS) is widely used for atraumatic mesh fixation in open and laparoscopic hernia surgery. Studies focusing on the optimization of sealant distribution are rare. This study elucidates the impact of spray distance and pressure, the thrombin concentration of the FS, as well as the mesh design on the spray process and the resulting sealant distribution.

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Background: Abdominal wall and inguinal hernia repair are the most frequently performed surgical procedures in the United States and Europe. However, traditional methods of mesh fixation are associated with a number of problems including substantial risks of recurrence and of postoperative and chronic pain. The aim of this systematic review is to summarize the clinical safety and efficacy of Tisseel/Tissucol fibrin sealant for hernia mesh fixation.

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Background: The atraumatic fixation of meshes by fibrin sealant (FS) has been established for both open and laparoscopic techniques of hernia repair. This study was performed to evaluate the use of FS in hernia mesh fixation with different polymerization speed (thrombin concentrations), using commercial hernia meshes, and in two techniques, transabdominal preperitoneal mesh placement (TAPP) and intraperitoneal mesh placement (IPOM).

Materials And Methods: A median laparotomy was performed in a pig model and hernia meshes were placed in IPOM and TAPP techniques.

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  • The study investigates the use of intra-peritoneal onlay mesh (IPOM) repair via transgastric access (TGA) to maintain abdominal wall integrity in NOTES procedures, potentially reducing post-operative pain and complications.
  • The experiment involved creating abdominal wall defects in pigs and fixing titanized polypropylene meshes with transfascial sutures and fibrin sealant, confirming successful integration without issues like shrinkage or inflammation.
  • Results indicate that IPOM repair in a NOTES hybrid procedure is practical and may offer benefits in minimizing surgical trauma to the abdominal wall.
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  • Bronchopleural fistulas (BPF) and air leaks (AL) are significant complications after lung surgeries, and the study compares the effectiveness and safety of fibrin sealants (FS) and cyanoacrylate glues (CA) in rabbits.
  • Although both sealants performed similarly in sealing effectiveness, CA caused higher tissue temperatures and more inflammation compared to FS, which was better tolerated.
  • The findings suggest that while CA is effective, its associated side effects may make FS a safer choice for tissue integration in surgical applications.
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  • The study evaluates the use of fibrin sealant (FS) for fixing titanized polypropylene mesh (TS) in pig models for hiatal closure procedures.
  • It involves surgical implantation in mini-pigs, assessing the effectiveness of the mesh and its attachment after four weeks, with positive outcomes in terms of tissue integration and lack of complications.
  • The results suggest that this method could be a safe and effective option for repairing hiatal hernias based on the findings from this experimental research.
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  • The study evaluated the safety and effectiveness of small intestine submucosa (SIS) as an alternative to synthetic meshes in intraperitoneal onlay mesh repair (IPOM), focusing on complications like adhesions and dislocation.
  • SIS was tested on 16 rats and two minipigs, with implants showing limited integration and some dislocation, despite no infections or seromas occurring.
  • The results indicate that SIS implants are prone to issues like shrinkage and adhesion formation, suggesting the need for more research into their use in hernia repairs.
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Introduction: The use of hiatal meshes for the repair of giant paraesophageal hernias (GPH) is associated with a significantly decreased rate of recurrences compared with mesh free techniques. Many surgeons refrain from mesh implantation at the gastroesophageal junction owing to reported complications, such as mesh migration, strictures, and risks of tack or suture placement. This case report presents the laparoscopic application of a titanium-coated mesh (TiSure, GfE, Germany) designated for hiatal repair, with fibrin sealant fixation (Tissucol, Baxter, Austria) in a patient with GPH.

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  • The study investigates the use of fibrin sealing with Tissucol on adhesion formation and tissue integration for mesh repair of ventral hernias in a rat model.
  • Results showed that meshes without fibrin sealing caused severe adhesions, while those with sealing had significantly milder adhesions and better integration into tissue.
  • Fibrin sealing also allowed for fewer sutures needed for mesh fixation, suggesting it can enhance surgical outcomes and reduce complications.
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Objectives: Various models of spinal cord injury in rodents have been established, and also techniques for lesion quantification. Measurement of the extent of the underlying injury is essential for monitoring the reproducibility of the experimental injury and assessment of therapeutic effects. In this study, we tested manganese-enhanced magnetic resonance imaging (MEMRI) for postmortem quantification of experimental spinal cord injury in rats.

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